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PubMed2006

Onwards and upwards.

Explore the source record for details and available documents.

Biochemical Phenomena↗
PubMed1995

Changes in study design, gender issues, and other characteristics of clinical research published in three major medical journals from 1971 to 1991.

OBJECTIVE: To examine trends in study design and other characteristics of original research published in JAMA, Lancet, and the New England Journal of Medicine (NEJM) between 1971 and 1991. DESIGN: A retrospective cross-sectional study of original clinical research published in JAMA, Lancet, and NEJM during 1971, 1981, and 1991. MEASUREMENTS: Four hundred forty-four articles were independently reviewed by at least two investigators and classified according to study design and other preselected study characteristics. Changes over time were analyzed by chi-square tests for categorical variables and analysis of variance for continuous variables. MAIN RESULTS: Clinical results doubled, from 17% of all articles in 1971 to 35% in 1991 (p < 0.004), while case series decreased from 30% to 4% (p < 0.0001). Of 118 clinical trials, randomized controlled trials increased from 31% to 76% (p < 0.003) and nonrandomized controlled trials decreased from 42% to 8% (p < 0.002). Multicenter studies increased from 10% to 39% (p < 0.0001) and the prevalence of health services research increased from none in 1971 to 12% in 1991 (p < 0.001). The proportion of the studies explicitly excluding women from the subject population decreased from 11% in 1971 to 3% in 1991 (p < 0.03). In 1991 7% of the studies were composed entirely of men subjects, while only 0.7% of the studies were specific to men's health. Twelve percent of the studies in 1991 were specific to women's health. Between 1971 and 1991 there was no change in the prevalence of women first authors or studies addressing women's or minorities' health issues. CONCLUSIONS: Several important changes in clinical research studies published in JAMA, Lancet, and NEJM have taken place between 1971 and 1991. Clinical trials have increased in frequency, largely replacing studies containing ten or fewer subjects. Health services research has increased in prevalence, reflecting growing interest in studies addressing the delivery of health care. Our data support the hypothesis that exclusion of women from clinical research studies is an important contributor to the paucity of data concerning women's health.

Clinical Trials as Topic↗
PubMed1995

Newspaper reporting of the medical literature.

OBJECTIVE: To examine whether the media are providing information to the public about important medical advances in a timely manner and whether the degree of importance is associated with other aspects of newspaper reporting (presence, extent, and prominence). DESIGN: The authors explored the amount, extent, prominence, and timeliness of newspaper coverage received by New England Journal of Medicine and JAMA articles published in 1988, by searching ten leading U.S. newspapers. The journal articles were independently rated based on the public's need to know the medical information contained in the article. The intraclass reliability coefficient for this need-to-know importance score was 0.77. MEASUREMENTS AND MAIN RESULTS: Overall, 35% of the journal articles received newspaper coverage (276/786). The articles were frequently covered by more than one newspaper [extensive coverage (161/276, 58%)] and often appeared on the front page [prominent coverage (42/276, 15%)]. Articles considered most important to the public (92/786, 12%) received more extensive and prominent coverage than did less important articles (p < 0.01). More than three fourths of the newspaper stories appeared within two days of the journal article's issue date. Stories about the most important articles appeared sooner than did those about the less important articles (p < 0.0001). CONCLUSIONS: Articles reported in two prominent medical journals are often viewed as being important to the public, and these articles are receiving newspaper coverage that is extensive, prominent, and timely. This is particularly true for those articles considered most important to the public.

Information Services↗
PubMed2000

How to read a systematic review.

A systematic review is a carefully planned and conducted study designed to answer a specific focused clinical question. A systematic review differs from the frequently encountered narrative review article. Systematic review must be completed using a prespecified methodology. The reader must ask eight important questions when reading a systematic review: (i) did the review address a focused clinical question (ii) is it likely that important, relevant studies are missed (iii) were the inclusion criteria used to select appropriate articles (iv) was the validity of the included studies assessed (v) were the assessments of studies reproducible (vi) were the results similar from study to study (vii) what were the overall results and how precise are they and (viii) will the results help in caring for patients. The article also provides sources for systematic reviews.

Evidence-Based Medicine↗
PubMed1997

An analysis of review articles published in four anaesthesia journals.

PURPOSE: To see if the authors of review articles in anaesthesia journals are making use of systematic methods in their preparation. METHODS: Twenty-five review articles published in 1995 in four major anaesthesia journals were analysed and compared with standard guidelines for the appraisal of reviews. RESULTS: Of the 25 articles, only 14 stated a clear purpose. Only two revealed the search strategy used to identity articles for the review. None of the reviews featured any type of quality assessment of the primary studies included, or stated what criteria, if any, were used to determine what material was included or excluded. Useful areas for future research were highlighted in only seven reviews. CONCLUSION: There is little evidence that reviews currently accepted for publication in anaesthesia journals have been prepared systematically.

Anesthesiology↗
PubMed2004

Conflicting interests: the evolution of an issue.

The systematic funding of University research has brought into relief a question of conflicting interests. The potential in funded research for conflict and the damaging effects that conflicting interests might have on civil society had been first noted by Eisenhower in the context of State-funded research. Since the 1980s, there has been greater concern with the corrosive effects of private or corporate funding on research. Initial efforts to manage the problems have focused on authorship declarations, but recent controversies with the SSRIs suggest the only way to manage the problem is by placing all clinical trial data in the public domain.

Access to Information↗